Tool for fixed customised relative alignment of adjustable orthopedic devices

ABSTRACT

An anatomy simulator can include a guide body having one or more faces. The anatomy simulator can include a first simulator socket forming a recess in a first face of the one or more faces. The first simulator socket can be configured to receive a first plate. The first simulator socket can include a first base portion. The anatomy simulator can include a bore extending from the base portion of the first simulator socket to an interior of the anatomy simulator. The bore can be configured to receive an alignment mechanism. The first base portion can be angled at a first angle with respect to the first face.

CLAIM OF PRIORITY

This application claims the benefit of U.S. Provisional PatentApplication Ser. No. 62/488,499, filed on Apr. 21, 2017, the benefit ofpriority of which is claimed hereby, and which is incorporated byreference herein in its entirety.

BACKGROUND

One or more conditions (e.g., injury, bone spurs, arthritis,developmental disorder, or the like) can affect a joint (e.g., ashoulder or hip joint) and necessitate a medical procedure (e.g., totalshoulder arthroplasty) to correct the one or more conditions. In anexample, a surgeon conducting a total shoulder arthroplasty on a patientcan place guide wires in the patient's anatomy to guide the surgeon inconducting the medical procedure.

SUMMARY

A problem to be solved can include the mal-alignment of replacementanatomy (e.g., a prosthetic device) during a medical procedure toinstall the replacement anatomy. Mal-alignment of replacement anatomycan be caused by a variety of factors (e.g., poor visibility of theanatomical feature undergoing the medical procedure, limited access tothe anatomy, guesswork by a surgeon, or the like). In an example, a lackof ability to observe the anatomy undergoing a medical procedure canresult in a mal-alignment of the replacement anatomy. Observation of theanatomy of the joint during the medical procedure can be hampered by theone or more conditions or by limited access to the joint itself (e.g.,other anatomical features are blocking physical access to, or visualinspection of, the anatomy under observation).

In an example, a diminished ability to observe the anatomical featurecan make it difficult to determine how to install the replacementanatomy as it relates to the anatomical feature (e.g., establish aproper orientation and position between the anatomical feature andreplacement anatomy). As discussed herein, a diminished ability toobserve the anatomical feature can make it difficult to determine theangular relationships (e.g., relative angles) required to be establishedbetween the anatomical feature and the replacement anatomy. A diminishedability to observe the anatomical feature can require expensive,pre-operative, medical imaging (and other pre-operative tasks) todetermine a desired orientation and position of the replacement anatomyin relation to the anatomical feature. In another example, even if theability to observe the anatomical feature is not diminished, and thepreferred orientation and position of the replacement anatomy inrelation to the anatomical feature can be determined during a medicalprocedure to install the replacement anatomy. The preferred orientationand position of the replacement anatomy in relation to the anatomicalfeature can be determined during the medical procedure by the use of anangular indicator.

In various embodiments of the systems and methods of the presentapplication, an anatomy simulator, such as an alignment block havingfaces with variously angled sockets, can be used to facilitate alignmentbetween medical device implant components and instrumentationcomponents, intra-operatively or pre-operatively, as discussed below.Such an alignment block can preemptively alleviate negative effects thatcan be associated with mal-alignment of replacement anatomy.

The mal-alignment of the replacement anatomy can have negative effectsupon the efficacy of the medical procedure. Additionally, pre-operativetasks can include fabrication of instruments that are specific to thepatient's anatomical feature. The patient-specific instruments can allowfor an individual (e.g., a radiologist, a surgeon, a nurse, or the like)to facilitate accurate alignment of the replacement anatomy in relationto the anatomical feature. However, patient-specific instrumentfabrication can be expensive, can require specialized equipment, such ascomputerized tomography scanners, or can take considerable time tofabricate the model. Further, because the instrument ispatient-specific, the instrument cannot be re-used in a differentmedical procedure.

In an example wherein a patient is undergoing a total shoulderarthroplasty procedure, the diminished ability to observe the anatomicalfeature of the shoulder joint can result in the mal-alignment, orimproper installation, of replacement anatomy (e.g., a shoulder jointreplacement apparatus). The mal-alignment of the replacement anatomy cannegatively affect the durability or performance of the replacementanatomy. In an example, the mal-alignment of the replacement anatomy cancause a premature loosening of the replacement anatomy from thepatient's anatomical feature or cause pain to the patient. A decrease inthe durability or performance of the replacement anatomy can necessitatefurther medical procedures, or otherwise negatively affect the qualityof life of the patient.

A solution to the aforementioned problems to be solved can include ananatomy simulator. In an example, the anatomy simulator can be analignment block or an alignment cube. The anatomy simulator can includea guide body having one or more faces. The anatomy simulator can includea first simulator socket. The first simulator socket can include arecess in a first face of the one or more faces. The first simulatorsocket can be configured to receive a first plate. The first simulatorsocket can include a first base portion, such as within the recess. Thefirst base portion can be angled at a first angle with respect to thefirst face. The anatomy simulator can include a bore. The bore canextend from the base portion of the first simulator socket to theinterior of the anatomy simulator. The bore can be configured to receivean alignment mechanism.

The anatomy simulator can be used to set relative angles between thefirst plate and the alignment mechanism. The anatomy simulator canprevent the mal-alignment of replacement anatomy by ensuring a proper,or a desired, angular alignment between the first plate and thealignment mechanism.

Aspect 1 can include or use subject matter (such as an apparatus, asystem, a device, a method, a means for performing acts, or a devicereadable medium including instructions that, when performed by thedevice, can cause the device to perform acts), such as can include oruse an anatomy simulator. The anatomy simulator can include a guide bodyhaving one or more faces. The anatomy simulator can include a firstsimulator socket forming a recess in a first face of the one or morefaces. The first simulator socket can be configured to receive a firstplate. The first simulator socket can include a first base portion. Theanatomy simulator can include a bore extending from the base portion ofthe first simulator socket to an interior of the anatomy simulator. Thebore can be configured to receive an alignment mechanism. The first baseportion can be angled at a first angle with respect to the first face.

Aspect 2 can include or use, or can optionally be combined with thesubject matter of Aspect 1, to optionally include or use that the firstplate and the alignment mechanism are configured to couple at one ormore orientations and coupling the first plate with the alignmentmechanism fixes the orientation of the first plate with respect to thealignment mechanism.

Aspect 3 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 or 2 to optionallyinclude or use that the first simulator socket is configured to receivethe first plate such that mating the first plate with the alignmentmechanism and with the first base portion establishes the first anglebetween the first plate and the alignment mechanism.

Aspect 4 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 through 3 tooptionally include or use that a portion of the alignment mechanism isquasi-spherical, and the quasi-spherical portion is configured to bereceived by a plate socket of the first plate.

Aspect 5 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 through 4 tooptionally include or use that the quasi-spherical portion includes anexpansion bore, wherein the expansion bore is configured to receive anexpansion pin, the expansion pin expanding the quasi-spherical portionfrom a first diameter to a second diameter.

Aspect 6 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 through 5 tooptionally include or use that expanding the quasi-spherical portionfrom a first diameter to a second diameter couples the first plate withthe alignment mechanism and fixes the orientation of the first platewith respect to the alignment mechanism.

Aspect 7 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 through 6 tooptionally include or use that the first simulator socket is included ina plurality of simulator sockets and each of the one or more facesincludes an individual simulator socket of the plurality of sockets.

Aspect 8 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 through 7 tooptionally include or use simulator indicia on the first face configuredto provide alphanumerical information identifying the first angle.

Aspect 9 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 through 8 tooptionally include or use that the first socket includes one or moreindicator portions configured to be aligned with an alignment indicia ofthe first plate.

Aspect 10 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 through 9 tooptionally include or use that the bore is configured to extendorthogonally to the first face.

Aspect 11 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 through 10 tooptionally include or use that the alignment mechanism is a guide wire.

Aspect 12 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 through 11 tooptionally include or use that the first face includes a first simulatorindicia configured to provide alphanumerical information identifying thefirst angle. The first simulator socket can include a first indicatorportion configured to receive an alignment indicia of the first plate.Aligning the alignment indicia with the first indicator portion andmating the first plate with the anatomy simulator can impart the firstangle onto the first plate with respect to the first face.

Aspect 13 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 1 through 12 tooptionally include or use the first plate. The first plate can include afirst plate surface configured to couple with an anatomical feature of apatient. The first plate can include a second plate surface opposite thefirst plate surface. The first plate can include a plate socketextending into the first plate surface. The first plate can include abore extending from the socket to the second guide plate surface toallow a guide wire to translate through the guide plate.

Aspect 14 can include or use subject matter (such as an apparatus, asystem, a device, a method, a means for performing acts, or a devicereadable medium including instructions that, when performed by thedevice, can cause the device to perform acts), such as can include oruse a method for calibrating adjustable orthopaedic devices. The methodcan include identifying an anatomical geometry of an anatomical featureof the patient, wherein the geometry of the anatomical feature includesan anatomical axis and the anatomical geometry is at one or more angleswith respect to the anatomical axis. The method can include coupling analignment mechanism to an anatomy simulator, wherein the anatomysimulator is configured to reproduce the one or more angles with respectto the alignment mechanism. The method can include coupling a firstplate with the anatomy simulator, wherein coupling the first plate withthe anatomy simulator includes mating the first plate with a baseportion of the anatomy simulator, wherein the mating of the first platewith the base portion establishes the first plate at the one or moreangles with respect to the alignment mechanism.

Aspect 15 can include or use, or can optionally be combined with thesubject matter of Aspect 14, to optionally include or use coupling anaxis guide to the first plate, wherein the alignment mechanism comprisesa first guide wire and coupling the axis guide includes translating thefirst guide wire through an axis guide wire bore of the axis guide, theaxis guide wire bore configured to receive the first guide wire in asingle orientation.

Aspect 16 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 14 or 15 tooptionally include or use decoupling the first plate and the axis guideas a unit from the anatomy simulator.

Aspect 17 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 14 through 16 tooptionally include or use placing a guide wire in the anatomical featureof the patient, wherein the coupling of the axis guide with the guideplate allows the guide wire to be located at the anatomical axis of theanatomical feature.

Aspect 18 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 14 through 17 tooptionally include or use mating the first plate with anatomy simulatorincludes mating the first plate with the alignment mechanism andestablishing the first angle between the first plate and the alignmentmechanism with the base portion of the anatomy simulator.

Aspect 19 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 14 through 18 tooptionally include or use that the first plate and the alignmentmechanism are configured to couple at one or more orientations andcoupling the first plate with the alignment mechanism fixes theorientation of the first plate with respect to the alignment mechanism.

Aspect 20 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 14 through 19 tooptionally include or use that a portion of the alignment mechanism isquasi-spherical, and the quasi-spherical portion is configured to bereceived by a plate socket of the first plate.

Aspect 21 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 14 through 20 tooptionally include or use expanding an expansion bore of thequasi-spherical portion, wherein the expansion bore is configured toreceive an expansion pin, the expansion pin expanding thequasi-spherical portion from a first diameter to a second diameter.

Aspect 22 can include or use, or can optionally be combined with thesubject matter of one or any combination of Aspects 14 through 21 tooptionally include or use identifying an anatomical geometry of ananatomical feature of the patient includes determining the one or moreangles of the anatomical geometry with respect to the anatomical axis.

Each of these non-limiting examples can stand on its own, or can becombined in various permutations or combinations with one or more of theother examples.

This overview is intended to provide an overview of subject matter ofthe present patent application. It is not intended to provide anexclusive or exhaustive explanation of the invention. The detaileddescription is included to provide further information about the presentpatent application.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, which are not necessarily drawn to scale, like numeralsmay describe similar components in different views. Like numerals havingdifferent letter suffixes may represent different instances of similarcomponents. The drawings illustrate generally, by way of example, butnot by way of limitation, various embodiments discussed in the presentdocument.

FIG. 1 is a perspective view of an adjustable orthopedic systemincluding a head, an adjuster, a stem, and a humerus.

FIG. 2 is a perspective view of the adjuster of FIG. 1 including anexpansion pin, a dome, and a ball-taper.

FIG. 3 is a cross-sectional view of the adjustable orthopedic system ofFIG. 1.

FIG. 4 is an anterior view of a humerus, and an angular indicator and afirst angular identification card for use with the adjustable orthopedicsystem of FIG. 1.

FIG. 5 is a superior view of the humerus and the angular indicator ofFIG. 4 and a second angular identification card for use with theadjustable orthopedic system of FIG. 1.

FIG. 6 is a schematic view of an alignment block mated with the adjustorfor use with the adjustable orthopedic system of claim 1.

FIG. 7 is a top view of the alignment block of FIG. 6.

FIG. 8 is a perspective view of an alignment cube for use with theadjustable orthopedic system of FIG. 1.

FIG. 9 a side view of another example of an adjustable orthopedic systemincluding another alignment cube and an alignment unit.

FIG. 10 is a posterior view of an example of a adjustable orthopedicsystem of FIG. 9 showing the alignment unit coupled with an anatomicalfeature.

DETAILED DESCRIPTION

As discussed herein, a diminished ability to observe an anatomicalfeature of a patient can make it difficult to determineintra-operatively how to install the adjustable orthopedic system 100(FIG. 1) as it relates to the anatomical feature, e.g., establish aproper orientation and position between the anatomical feature andreplacement anatomy. The preferred orientation and position of thereplacement anatomy (e.g., a head 110, an adjuster 120 and a stem 130)in relation to the anatomy can be determined during the medicalprocedure by the use of an angular indicator (e.g., angular indicator410 of FIG. 4 or angular indicator 510 of FIG. 5).

Also, a diminished ability to observe an anatomical feature of a patientcan make it difficult to determine how to assemble and install theadjustable orthopedic system 900 (see FIG. 9), e.g., establish a properorientation between components of an instrumentation systems. Thepreferred orientation and position of components of the orthopedicsystem 900 (e.g., guide plate 951 and the axis guide 952) can bedetermined pre-operatively using medical imaging.

An anatomical simulator (e.g., the alignment block 630 of FIGS. 6 and 7,or the alignment cube 830 of FIG. 8) can be used to intraoperatively toconfigure the relative angles between the anatomical feature and thereplacement anatomy. The anatomical simulator can be used to set therelative angles of components of the replacement anatomy (e.g., betweenthe head 220 and the ball taper 230 of the adjustor 120 of FIGS. 1-3).

An anatomical simulator (e.g., alignment cube 930 of FIG. 9) can be usedto pre-operatively configure the relative angles between the guide plate951 and the axis guide 952 of FIGS. 9 and 10. In an example, the anatomysimulator can be an alignment block (e.g., the alignment block 630 ofFIGS. 6 and 7) or an alignment cube (e.g., the alignment cube 830 ofFIG. 8, or the alignment cube 930 of FIG. 9). The anatomy simulator caninclude a guide body having one or more faces with angled sockets, asdiscussed below. The anatomy simulator, such as an alignment cube, canbe used to set relative angles between various components. The anatomysimulator can prevent the mal-alignment of replacement anatomy orsurgical instrumentation by ensuring a proper, or a preferred, angularalignment between components.

FIG. 1 is a perspective view of an adjustable orthopedic system 100including a head 110, an adjuster 120, a stem 130, and a humerus 140.The head 110 can be configured to replicate a portion of an anatomicalfeature of a patient. The head 110 can have a circular cross section.The head 110 can have a round, or oval cross section. The head 110 canhave a non-uniform cross section. The head 110 can replicate a portionof a humeral head. The head 110 can replicate a portion of a femoralhead. In an example, a patient's humeral head is misshapen (e.g., due toinjury, disease, malformation, or the like). As shown in FIG. 1, aportion of the humeral head can be removed from a remaining portion ofthe humerus. The head 110 can be coupled to the remaining portion of thehumerus. The head 110 can provide an improved surface for the humerus tomate with the scapula, such as by providing a smooth, consistent surfacefree from protrusions (e.g., malformations) or debris (e.g., bonespurs).

The head 110 shown in FIG. 1 can be a provisional head used fordetermining the correct size and shape of a head 110 to be permanentlycoupled with the anatomical feature. As previously discussed, a portionof the anatomical feature can be removed. The dimensions and orientationof the anatomical feature can vary from a first patient to a secondpatient. Use of the provisional head can allow for a medicalpractitioner to determine the correct configuration of the head 110 topermanently couple with the anatomical feature of the patient. Theprovisional head can include indicia (e.g., markings) that indicate whattype (e.g., circular or non-circular cross section) and/or size of head110 can be permanently coupled to the anatomical feature.

The head 110 can be coupled to the adjustor 120. The head 110 can becoupled to the adjustor 120 in one or more orientations. The coupling ofthe head 110 to the adjustor 120 can be referred to as positionablemating of the head 119 with the adjustor 120. Positionable mating of thehead 110 with the adjustor 120 can also be referred to as fixablepositioning. Fixable positioning of the adjustor 120 can include whenthe position, or orientation, of the components of the adjustor 120remain fixed, or unchanged, once the position or orientation of thosecomponents has been established or set, such as by a surgeon. Asdiscussed herein, fixable positioning can be achieved by an interferencefit between the components of the adjustor 120. The adjustor 120 can beconfigured to allow fixable positioning of the adjustor 120 componentsto allow for the adjustor 120 to adapt to variations in an anatomicalfeature of a patient.

As shown in FIG. 1, a portion of the humerus 140 has been cut away andremoved (e.g., the humerus 140 has been resected). The angle of the cutcan vary upon needs of a patient, such as by accounting for malformationor damage to the portion of the humerus 140 being removed. The resectedportion of the humerus 140 can have a flat face 143. The fixablepositioning of the adjustor 120 can allow for a wide range of angularrelationships between the head 110, the stem 130, and the humerus 140 tobe achieved. Stated another way, the adjustor 120 allows fornon-patient-specific components (e.g., the head 110 and the stem 130) tobe configured into a patient-specific orientation or relationship withrespect to the humerus 140. Although the humerus 140 is the anatomicalfeature under discussion, the devices and methods described herein canbe used with various anatomies, such as hips, shoulders, and the like.

The stem 130 can be configured to couple with the humerus 140. The stem130 can couple with a medullary cavity of the humerus 140. A cavity 145(e.g., the medullary cavity) can be made in the humerus 140. The cavity145 can be configured to receive the stem 130. The cavity 145 can belocated at the portion of the humerus 140 that has been cut away andremoved. The cavity 145 can extend into the interior of the humerus 140.The stem 130 can have a rough exterior surface for increasing thecoefficient of friction of the exterior surface, thereby improving thecoupling of the stem 130 with the humerus 140. The stem 130 can becoupled to the humerus 140 with an adhesive (e.g., glue, epoxy, cement,or the like). The volume of the cavity 145 surrounding the stem 130 canbe filled with the adhesive. Coupling the stem 130 to the humerus 140with an adhesive can improve the strength and resiliency of the couplingof the stem 130 to the humerus 140. Coupling the stem 130 with thehumerus 140 can allow for other structures, such as the adjuster 120, tobe coupled to the stem 130 and thereby to the humerus 140. The stem 130can have a coupler 135 configured to allow the adjustor 120 to coupleand decouple from the stem 130. The adjustor 120 can be configured toinclude an adjustor coupling feature that corresponds to the coupler130, such that the adjustor 120 can couple and decouple from the stem130.

FIG. 2 is a perspective view of the adjuster 120 of FIG. 1 including anexpansion pin 210, a dome 220, and a ball-taper 230. The dome 220 can beconfigured to be orientated in a plurality of positions with respect tothe ball-taper 230. Stated another way, the dome 220 has numerousdegrees of freedom and can be positioned at a variety of angles withrespect to the ball-taper 230. As discussed herein, the adjustor 120 canbe configured to allow the fixable positioning of the components of theadjustor 120. Stated another way, the adjustor 120 can be configured toallow for the orientation of the dome 220 relative to the ball-taper 230to be fixed once the orientation has been established.

The dome 220 can be a first plate. The dome 220 can include a domesocket 260. The dome socket 260 can be configured to receive a head 240of the ball-taper 230. The dome socket 260 can be configured topositionably mate with the head 240 of the ball-taper 230. In anexample, the head 240 of the ball-taper 230 can be quasi-spherical andthe dome socket 260 can be sized and shaped such that the dome 220 isloosely coupled (e.g., able to freely be reoriented) with the ball-taper230.

The ball-taper 230 can be an alignment mechanism. The ball-taper 230 caninclude one or more expansion slots 250. The one or more expansion slots250 can be configured to expand in response to an applied force.Expansion of the one or more expansion slots 250 can change (e.g.,increase or decrease) the dimensions of the ball-taper 230. Expansion ofthe one or more expansion slots 250 can change the dimensions of thehead 240. Expansion of the one or more expansion slots 250 can changethe head 240 from a first diameter to a second larger diameter.

The expansion of the one or more expansion slots 250 can be achieved byallowing a petal 235 to deflect. The adjustor 120 can include one ormore petals.

The ball-taper 230 can include an expansion bore 270. The expansion bore270 can be included in the head 240. The expansion bore 270 can have acircular cross section. The expansion bore 270 can be tapered. The oneor more expansion slots 250 can extend from the exterior of theball-taper 230 to the expansion bore 270. The expansion bore 270 can beconfigured to receive the expansion pin 210. The one or more petals candefine the expansion bore 270.

The expansion pin 210 can be a cylinder with a constant diameter. Theexpansion pin 210 can include a cone portion (e.g., the diameter of theexpansion pin 210 changes linearly along a portion of a length of theexpansion pin 210). The expansion pin 210 and expansion bore 270 can beconfigured such that when the expansion pin 210 is translated into theexpansion bore 270, the one or more petals deflect. The deflection ofthe one or more petals can cause the expansion slots 270 to expand. Theone or more expansion slots 270 can expand outward (e.g., toward theexterior) from the ball-taper 230.

In an example, the expansion pin 210 can be tapered and can betranslated into the expansion bore 270. As the expansion pin 210 istranslated into the expansion bore 270, a portion of the expansion pin210 engages with, and acts upon, the expansion bore 270. The expansionbore 210 can be a smooth bore with a consistent diameter. The one ormore expansion slots 240 can allow for the diameter of the expansionbore 270 to change.

The one or more expansion slots 240 can allow for the diameter of theexpansion bore 270 to change as the expansion pin 210 is translatedwithin the expansion bore 270. As the expansion pin 210 is translateddeeper into the expansion bore 270, the larger diameter portion of theexpansion pin 210 begins engaging with the expansion bore 270. Continuedtranslation of the expansion pin 210 within the expansion bore 270forces the diameter of the expansion bore 270 to increase and match thelargest diameter portion of the expansion pin 210 that is engaging withthe expansion bore 270. Expansion of the expansion bore 270 can beaccomplished by tapering the expansion pin 210, the expansion bore 270,or tapering both the expansion pin 210 and the expansion bore 270.Expansion of the expansion bore 270 can cause the one or more petals todeflect. Other configurations are possible for expanding the expansionbore 270, such as by using fasteners, electo-mechanical components,hydraulic components, or the like.

Expanding the expansion bore 270 can allow for the dome 220 topositionably mate with the ball-taper 230. Postionable mating can occurthrough an interference fit between the dome 220 and the ball-taper 230.The expansion bore 270 can be expanded by the expansion pin 220, therebydeflecting the one or more expansion slots 240 outward. The outwarddeflection of the expansion slots 240 changes the diameter of the head240 from a first diameter to a second diameter. The dome socket 260 canbe configured to have substantially the same shape as the head 240 ofthe ball-taper 230. The dome socket can have the second diameter.Expanding the expansion bore 270 can force the head 240 to engage withthe dome socket 260. The expansion bore 270 can be expanded such thatthe dome 220 and the ball-taper 230 become positionably mated. Furthertranslation of the expansion pin 210 within the expansion bore 270 cangenerate greater frictional forces between the head 220 and the domesocket 260, thereby tightening the coupling between the dome 220 and theball-taper 230. Stated another way, translating the expansion pin 210deeper into the expansion bore 270 can increase an amount of forcenecessary to reorient the dome 220 with respect to the ball-taper 230.

Assembly of the adjustor 120 can be accomplished by mating the dome 220with the ball-taper 230. As described herein, the orientation of thedome 220 with respect to the ball-taper 230 can be established by usingan alignment block (e.g., the alignment block 630 of FIG. 6) or analignment cube (e.g., the alignment cube 830 or 930 of FIG. 8 or 9,respectively). The alignment block or alignment cube can establish therelative angles between the dome 220 and the ball-taper 230. The dome220 can include a through-hole configured to allow the expansion pin 210to translate through the through-hole. The through-hole in the dome 220can be configured to allow the expansion pin 210 to translate throughthe dome 220 and into the expansion bore 270 of the ball-taper 230. Theexpansion pin 210 can be inserted into the expansion bore 270 once theorientation of the dome 220 with respect to the ball-taper 230 has beenestablished. As discussed herein, the expansion pin 210 can fix theorientation of the dome 220 with respect to the ball-taper 230 byforcing the petals 235 to push against dome socket 260.

FIG. 3 is a cross-sectional view of the adjustable orthopedic system 100of FIG. 1. The adjustable orthopedic system 100 can include the head110, the adjustor 120, the stem 130, and the humerus 140. The humerus140 can include a first axis 300A, a second axis 300B, and a third axis300C. The first axis 300A, second axis 300B, and the third axis 300C canbe referred to collectively as the axes 300A, 300B, and 300C. The firstaxis 300A and the second axis 300B can be offset at a first angle α. Thesecond axis 300B and the third axis 300C can be offset at a second angleβ. The first axis 300A and the third axis 300C can be offset at a thirdangle Θ. The humerus 140 can have a fourth axis (e.g., the fourth axis500 of FIG. 5). The fourth axis can extend orthogonally to the first andsecond axis 300A and 300B. Stated another way, the fourth axis canextend perpendicular to the sheet.

As discussed herein, a portion of an anatomical feature can be cut andremoved (e.g., resected). As shown in FIG. 3, axis 300C extendslongitudinally through the humerus 140. A portion of the humerus 140(e.g., a portion of the head) has been resected. The resected portion ofthe humerus 140 can have a flat face (e.g., the flat face 143 of FIG.1). The axis 300B can be collinear with the face of the resectedportion. The face can be oriented at the angle α with respect to theaxis 300C. The adjustor 120 can articulate to match the angle α. Statedanother way, the adjustor 120 can be configured to be orientated at theangle α with respect to the axis 300C. As shown in FIG. 3, the axis 300Acan be a longitudinal axis of the stem 130. The stem 130 can beorientated at the angle α such that the coupler 135 is orthogonal to theface. In an example, the stem 130 is oriented at an angle different thanα. The adjustor 120 can be configured to couple with the stem 130 suchthat the head 110 will be parallel (e.g., able to mate withsubstantially no gaps) to the flat face of the humerus 140. Statedanother way, the adjustor 120 can be configured to compensate forangular misalignment between the head 110 and the stem 130. The adjustor120 can compensate for angular misalignment between the stem 130 and thehead 110 by articulating at the angle Θ. The adjustor 120 can beconfigured to articulate in the direction of the second axis 300B.

As discussed herein, the humerus 140 can have a fourth axis (e.g., thefourth axis 500 of FIG. 5). The fourth axis can extend orthogonally tothe first and second axis 300A and 300B. Stated another way, the fourthaxis can extend perpendicular to the plane of FIG. 3. The adjustor 120can be configured to articulate in the direction of the fourth axis 500.Articulating in the direction of the fourth axis can compensate forangular misalignment between the stem 130 and the head 110, such as whenthe flat face has a slope in the direction of the fourth axis.

FIG. 4 is an anterior view of a humerus 140, and an angular indicator400 and a first angular identification card 410 for use with theadjustable orthopedic system 100 of FIG. 1. The angular indicator 400can include a first finger 420, a second finger 430, and a base plate440. The first finger 420 and the second finger 430 can extendorthogonally from the base plate 440. The angular identification card410 can be mated with a reference surface (e.g., the base plate 440 orthe face 143 of FIG. 1). The angular identification card 410 can belocated proximate to the angular indicator 400 such that an angularindicia, such as an angular indicia 450, to be seen between the firstand second fingers 420 and 430.

The base plate 440 can include an indicator coupling feature configuredto couple and decouple with a coupler (e.g., the coupler 135 of FIG. 1)of the stem 130, such that the angular indicator 400 can couple anddecouple from the stem 130. The first and second fingers 420 and 430 canbe parallel in relation to each other. The first and second fingers 420and 430 can be spaced apart at a first distance. Spacing the first andsecond fingers 420 and 430 at the first distance can allow for theangular indicia 450 of the first angular identification card 410 to beseen between the first and second fingers 420 and 430.

In an example, the first and second fingers 420 and 430 can provide anindication of the angle Θ between the first axis 300A and the secondaxis 300B. The angular indicia 450 can provide an indication of theangle Θ. The first and second fingers 420 and 430 can be configured toprovide an indication of an angle between any combination of the firstaxis 300A, second axis 300B, third axis 300C, or the fourth axis (e.g.,the fourth axis 500 of FIG. 5). The first and second fingers 420 and 430can include finger indicia. The first angular identification card 410can include card indicia that correspond to the finger indicia to ensurethat the first angular identification card is being used with the firstand second fingers 420 and 430 and thereby provide the correct angle Θ.

FIG. 5 is a superior view of the humerus 140 and the angular indicator400 of FIG. 4 and a second angular identification card 510 for use withthe adjustable orthopedic system 100 of FIG. 1. The angular indicator400 can include the second finger 430 and a third finger 520. Inclusionof the third finger 520 can allow for the angular relationship ofmultiple axis (e.g., the first axis 300A, second axis 300B, third axis300C, or a fourth axis 500) to be determined without decoupling theangular indicator 400 from the stem 130. The second and third fingers430 and 520 can allow for an angle γ between the first axis 300A and thefourth axis 500 to be determined.

FIG. 6 is a schematic view of an alignment block 630 mated with theadjustor for use with the adjustable orthopedic system 100 of claim 1.The alignment block 630 can be an anatomy simulator. The alignment block630 can include a body. The alignment block 630 can be used to setrelative angles between a dome (e.g., the dome 220 of FIG. 1) and a balltaper (e.g., the ball-taper 230 of FIG. 1). The alignment block 630 canbe used to set the angles α, β, Θ, and γ. In an example, the alignmentblock 630 can include a face 600, an alignment bore 610, a base portion620, one or more block indicia 640A, 640B, 640C, and 640D, a slot 650.

In an example, the face 600 can include the slot 650. The slot 650 caninclude the base portion 620. The slot 650 can be configured to receivethe dome. The slot 650 can be configured to receive the dome in aplurality of orientations. The reception of the dome by the slot 650 canmate the dome with the base portion 620 of the slot 650. The alignmentbore 610 can extend from the face 600 to another face located on theopposite side of the alignment block 630. The alignment bore 610 can beconfigured to receive a ball taper (not shown) in one or moreorientations. As shown in FIG. 6, the alignment bore 610 can beconfigured such that the ball taper can be received by the alignmentbore 610 in four orientations. The alignment bore 610 can include afirst lobe 660A, a second lobe 660B, a third lobe 660C, and a fourthlobe 660D. Additional or fewer lobes can be included in the alignmentbore 610.

In an example, the base portion 620 of the slot 650 can be configured asan inclined plane. Stated another way, the bottom (e.g., the baseportion 620) of the slot 650 can be angled at an angle μ (e.g., theangle μ of FIG. 7) such that a first distance from a first side of theslot 650 to the face 600 can be different than a second distance fromthe bottom of a second side of the slot 650 to the face 600. Stated yetanother way, the depth of the slot 650 relative to the face 600 can varyover the area of the slot 650. The base portion 620 of the slot 650 canbe configured to include a plurality of inclined planes. The inclinedplane can have an angular slope from a first end of the inclined planeto a second end of the inclined plane. The one or more block indicia640A, 640B, 640C, and 640D can be used to identify the angular slope ofthe inclined plane. The one or more block indicia 640A, 640B, 640C, and640D can respectively be aligned with the first, second, third, andfourth lobes 660A, 660B, 660C, and 660D. The angle μ can equal theangles α, β, Θ, and γ.

FIG. 7 is a top view of the alignment block of FIG. 6. The ball-taper230 can include lobes (not shown) configured to correspond with thefirst, second, third, and fourth lobes 660A, 660B, 660C, and 660D. Thelobes of the ball-taper 230 can correspond with the first, second,third, and fourth lobes 660A, 660B, 660C, and 660D such that theball-taper 230 is received by the alignment bore 610 in one of fourorientations, although additional or fewer orientations are possible.The first, second, third, and fourth lobes 660A, 660B, 660C, and 660Dcan be used to orientate the ball-taper 230 with respect to thealignment block 630. The ball-taper 230 can include an alignment indicia(not shown) used for maintaining the orientation of the ball taper. Forexample, the alignment indicia can be a colored portion of theball-taper 230 that allows an individual to consistently orientate theball-taper 230. The alignment indicia can be other markings on the balltapper 230 that allows for an individual to consistently orientate theball-taper 230. The alignment indicia can be used to orientate theball-taper 230 with respect to the stem 130 (shown in FIGS. 1 and 3)such that the orientation imparted to the adjustor 120 can betransferred to the adjustable orthopedic system 100.

The alignment indicia (not shown) can be aligned with the first lobe660A. In an example, aligning the alignment indicia with the first lobe660A and placing the alignment unit 120 within the slot 650 (e.g.,mating the dome 220 with the slot 650, and the ball-taper 230 with thealignment bore 610) results in the dome 220 being angled at a 10 degreeangle relative to the face 600 of the alignment block 630 (and theball-taper 230). In another example, aligning the alignment indicia withthe second lobe 660B and placing the adjustor 120 within the slot 650results in the dome 220 being angled at a 10 degree angle relative tothe face 600 of the alignment block 630 (and the ball-taper 230).However, by aligning the alignment indicia with the second lobe 660Binstead of the first lobe 660A, the 10 degree angle relative to the face600 will be reoriented into a different orientation with respect to thealignment block 630 (and the ball-taper 230). Stated another way,aligning the alignment indicia with the second lobe 660B instead of thefirst lobe 660A can allow for the dome 220 to be oriented at a 10 degreeangle with respect to the face 600, but the direction of the tilt willdiffer depending upon the orientation of the adjustor 120 within theslot 650. Once the relative angles between the dome 220 and theball-taper 230 have been established, the expansion pin 210 (shown inFIG. 2) can be driven into the expansion bore 270 (shown in FIG. 2),thereby temporarily fixing the position of the dome 220 with respect tothe ball-taper 230.

In an example, the alignment indicia (not shown) can be positioned inthe superior direction when the adjustor 120 is coupled with the stem130 (shown in FIGS. 1 and 3). The base portion 620 of the alignmentblock 630 can be at an angle with respect to the face 600. In theexample of FIG. 7, the base portion 620 can slope downward at a 10degree angle (e.g., the angle μ is equal to 10 degrees) from left toright (e.g., the right side of the base portion 620 will have a greaterdepth than the left side of the base portion 620). In an example, amedical practitioner is operating on a patient's left-side scapula.Placing the adjustor 120 within the slot 650 such that the alignmentindicia (not shown) is aligned with the first lobe 660A, can result inthe dome 220 having 10 degrees of retroversion tilt when coupled to theleft-side scapula. However, if the dome 220 were coupled to a right-sidescapula, the dome 220 would have 10 degrees of anteversion tilt.Furthermore, if the adjustor 120 were positioned so that the alignmentindicia is aligned with third lobe 660C, the adjustor 120 would beconfigured to provide 10 degrees retroversion tilt for a right shoulder.

Placing the adjustor 120 within the slot 650 such that the alignmentindicia is aligned with the second lobe 660B, can result in the dome 220(with respect to the ball-taper 230) having 10 degrees of superior tiltwhen coupled to the left-side scapula. Placing the adjustor 120 withinthe slot 650 such that the alignment indicia is aligned with the fourthlobe 660D can result in the dome 220 having 10 degrees of inferior tilt(with respect to the ball-taper 230) when coupled to the left-sidescapula. Because the inferior/superior relationship is unaffected bywhich side of the body an anatomical feature is located on, the dome 220can have 10 degrees of inferior tilt or superior tilt when coupled to aright-side, or a left-side scapula when using fourth and second lobes660D and 660B, respectively.

The positionable mating of the ball-taper 230 and the dome 220 can allowfor the position, or orientation, of the ball-taper 230 relative to thedome 220 to remain temporarily fixed, or unchanged, once the position ororientation has been established or set, such as by a surgeon using thealignment block 630. The ball-taper 230 and the dome 220 can have morethan one relative angle set (e.g., the angles α, β, Θ, and γ). In anexample, the angle α can be in a first plane. The ball-taper 230 and thedome 220 can be set at a second angle β along a second plane. The firstplane can be different than the second plane. The first plane can beorthogonal to the second plane. Additional relative angles and planesare capable of being used with the ball-taper 230 and the dome 220. Themated (e.g., coupled) ball-taper 230 and the dome 220 can be removed(e.g., decoupled) from the alignment block 630 as the adjustor 120. Theadjustor 120 can maintain the relative angles between the ball-taper 230and the dome 220 that were set using the alignment block 630.

An individual (e.g., a radiologist, a surgeon, a nurse, or the like) candetermine the anatomical geometry of a patient by performing medicalimaging on an anatomical feature of the patient. In an example, x-rayimages can be taken of the anatomical feature in various reference planviews (e.g., superior, anterior, medial, or the like). The anatomicalgeometry, such as the angular relationship of the anatomical featurewith respect to another anatomical feature or the reference plan views,can be determined by the individual from the x-rays. The individual canuse the alignment block 630 to establish the relative angles between thedome 220 and the ball-taper 230. The relative angles can besubstantially similar (e.g., within 10 degrees) to the angularrelationship determined from the x-rays. Use of x-rays and the alignmentblock 630 can eliminate the need for more expensive forms of medicalimaging. Use of x-rays and the alignment block 630 can eliminate theneed for fabricating a patient specific model of the anatomical feature.Fabrication of the patient specific model can be expensive.Additionally, the alignment block 630 can be included in a set ofalignment blocks. The set of alignment blocks can provide a variety ofcombinations of superior, inferior, anteversion and retroversionsettings.

FIG. 8 is a perspective view of an alignment cube 830 for use with theadjustable orthopedic system 100 of FIG. 1. The alignment cube 830 canbe an anatomy simulator. The alignment cube 830 can be similar to thealignment block 630, such as including similar features, but providingadditional configuration options. The alignment cube 830 can include afirst face 800A, a second face 800B, a third face 800C, a firstalignment bore 810A, a second alignment bore 810B, a third alignmentbore 810C, a first slot 820A, a second slot 820B, and a third slot 830C.The face 600 of FIGS. 6 and 7 can be one of six faces of the alignmentcube 830. Stated another way, the first face 800A can be the alignmentblock 600 of FIGS. 6 and 7.

The alignment cube 830 can provide additional combinations of superior,inferior, anteversion and retroversion settings than the alignment block630. The alignment cube 830 can have different combinations of superior,inferior, anteversion and retroversion settings than the alignment block630. In an example, the first slot 820A can impart an angle to the dome220 relative to the first face 800A. The angle can vary depending uponwhat face of the alignment cube 830 is used (e.g., the angle is 10degrees for the first face 800A, but the angle for the other faces ofalignment cube 830, such as the second or third face 800B or 800C, willbe greater than, or less than, 10 degrees). The angle can vary dependingupon which alignment cube is used in the set of alignment cubes (e.g.,the is 10 degrees for the alignment cube 830, but the angle for otherguide cubes will be greater than, or less than, 10 degrees). The anglefor the alignment block 630 or the alignment cube 830 can vary inincrements of 0.25 degrees, 0.5 degrees, 1 degree, 5 degrees, or 10degrees, but other increments are possible. The alignment block 630 andthe alignment cube 830, or the set of alignment blocks or set ofalignment cubes, can be used with a first patient and reused withsubsequent patients after sanitizing.

FIG. 9 a side view of another example of an adjustable orthopedic system900 including another alignment cube 930 and an alignment unit 950. Thealignment cube 930 can be used to set relative guide plates betweencomponents of the alignment unit 950. The alignment unit 950 can includea guide plate 951 and an axis guide 952. The axis guide 952 can includea second guide wire bore 953.

The alignment cube 930 can include a first guide wire bore 910. Theguide wire bore 910 can be configured to receive a guide wire 915 (e.g.,a rigid cylinder used for surgical procedures). The alignment cube 930can include features similar to the alignment cube 830 or the alignmentblock 630. The guide wire 915 can extend orthogonally from a face 905 ofthe alignment cube 930. The alignment cube 930 can have one or moreslots, such as a slot 920. The one or more slots can be configured tohave one or more inclined planes, such as inclined plane 940. In anexample, the guide plate 951 and the guide wire 915 can be mated withthe alignment cube 930. The guide wire 915 extends orthogonally from theface 905 and through the guide wire bore (e.g., the guide wire bore 1020of FIG. 10) of the guide plate 951.

The guide plate 951 can be mated with the inclined plane 940 of a slot.The inclined plane 940 imparts an angle Θ to the guide plate 951relative to the face 905. The relative angle Θ between the guide plate951 and the face 905 can be the same as the relative angle between theguide plate 951 and the guide wire 915. The guide wire 915 can be ableto extend through the guide plate 951 at an angle because the firstguide wire bore (not shown) of the guide plate 951 can be configured toallow the guide wire 915 to translate through the guide plate 951 in oneor more orientations.

In an example, the guide plate 951 can be mated with the alignment cube930 and the guide wire 915 can be mated with the alignment cube 930 andtranslated through the guide plate 951. The guide plate 951 has an anglerelative to the alignment cube 930. The guide plate 951 has an angle(e.g., 1, 2, 5, 10, 15, 25, or 90 degrees) relative to the guide wire915.

The axis guide 952 can include the second guide wire bore 953. Thesecond guide wire bore 953 can be configured to receive a guide wire(e.g., the guide wire 915) in a single orientation (e.g., the axis guidecan be able to translate or slide along the guide wire). The receptionof the guide wire by the axis guide 952 can make a longitudinal axis ofthe guide wire collinear with a longitudinal axis of the second guidewire bore 953.

The axis guide 952 can include a head 954. The head 954 can beconfigured to mate with, or couple with, a socket (e.g., socket 1010 ofFIG. 10) of the guide plate 951. The mating of the head 954 and thesocket can allow for a fixable positioning of the axis guide 952relative to the guide plate 951. In an example, the guide plate 951 canbe mated with a slot of the alignment cube 930 and can be oriented at afirst angle with respect to a face of the alignment cube 930. Therelative angle between the axis guide 952 and the guide plate 951 can bethe first angle when a guide cube can be used in combination with theguide plate 951 and the axis guide 952. The axis guide 952 can betranslated along the guide wire 915 and brought into communication withthe socket of the guide plate 951. The axis guide 952 can require apredetermined force (e.g., a surgeon applying a force, such as a hammerstrike, to an end of the axis guide 952) to mate, or couple, the axisguide 952 with the guide plate 951.

The positionable mating of the axis guide 952 and the guide plate 951can allow for the position, or orientation, of the axis guide 952relative to the guide plate 951 to remain temporarily fixed, orunchanged, once the position or orientation has been established or set,such as by a surgeon using a alignment cube 930. Because the axis guidewas translated over the guide wire 915 and the guide wire 915 can be atthe first angle relative to the guide plate, the positionable mating ofthe axis guide 952 with the guide plate 951 can set the relative anglesbetween the axis guide 952 and the guide plate 951 at the first angle.The axis guide 952 and the guide plate 951 can have more than onerelative angle set. In an example, the first angle can be in a firstplane. The axis guide 952 and the guide plate 951 can be set at a secondangle along a second plane. The first plane can be different than thesecond plane. The first plane can be orthogonal to the second plane.Additional relative angles and planes are capable of being used with theaxis guide 952 and the guide plate 951. The mated (e.g., coupled) axisguide 952 and the guide plate 951 can be removed (e.g., decoupled) fromthe alignment cube 930 and the guide wire 915 as the alignment unit 950.The alignment unit 950 can maintain the relative angles between the axisguide 952 and the guide plate 951 that were set using the alignment cube930.

FIG. 10 is a posterior view of an example of the adjustable orthopedicsystem 900 of FIG. 9 showing the alignment unit 150 coupled with ananatomical feature 1000. The anatomical feature 1000 can be a scapula ora hip bone. The alignment unit 950 can include an axis guide 952 and aguide plate 951. The guide plate 951 can include a guide wire boreconfigured to allow a guide wire to translate through the guide wirebore in one or more orientations. The relative angles between the axisguide 952 and the guide plate 951 can remain fixed once they have beenset, such as through the interaction of one or more surface features ona head 954 of the axis guide and a socket 1010 of the axis guide 120. Inan example, the alignment unit 950 can be used to install a guide wirein a patient's anatomical feature (e.g., the anatomical feature 1000).The alignment unit 950 can allow for the guide wire to be installed atthe relative angles that were established between the axis guide 952 andthe guide plate 951.

As previously discussed, an individual (e.g., a radiologist, a surgeon,a nurse, or the like) can determine the anatomical geometry of a patientby performing medical imaging on an anatomical feature of the patient.In an example, x-ray images can be taken of the anatomical feature invarious reference plan views (e.g., superior, anterior, medial, or thelike). The anatomical geometry, such as the angular relationship of theanatomical feature with respect to another anatomical feature or thereference plan views, can be determined by the individual from thex-rays. The individual can use the alignment cube 930 (or the alignmentblock 630 of FIG. 6 or the alignment cube 830 of FIG. 8) to establishthe relative angles between the guide plate 951 and the axis guide 952.The relative angles can be substantially similar (e.g., within 10degrees) to the angular relationship determined from the x-rays. Use ofx-rays and the alignment cube 930 can eliminate the need for moreexpensive forms of medical imaging. Use of x-rays and the alignment cube930 can eliminate the need for fabricating a patient specific model ofthe anatomical feature. Fabrication of the patient specific model can beexpensive.

Various Notes

The above description includes references to the accompanying drawings,which form a part of the detailed description. The drawings show, by wayof illustration, specific embodiments in which the invention can bepracticed. These embodiments are also referred to herein as “examples.”Such examples can include elements in addition to those shown ordescribed. However, the present inventors also contemplate examples inwhich only those elements shown or described are provided. Moreover, thepresent inventors also contemplate examples using any combination orpermutation of those elements shown or described (or one or more aspectsthereof), either with respect to a particular example (or one or moreaspects thereof), or with respect to other examples (or one or moreaspects thereof) shown or described herein.

In the event of inconsistent usages between this document and anydocuments so incorporated by reference, the usage in this documentcontrols.

In this document, the terms “a” or “an” are used, as is common in patentdocuments, to include one or more than one, independent of any otherinstances or usages of “at least one” or “one or more.” In thisdocument, the term “or” is used to refer to a nonexclusive or, such that“A or B” includes “A but not B,” “B but not A,” and “A and B,” unlessotherwise indicated. In this document, the terms “including” and “inwhich” are used as the plain-English equivalents of the respective terms“comprising” and “wherein.” Also, in the following claims, the terms“including” and “comprising” are open-ended, that is, a system, device,article, composition, formulation, or process that includes elements inaddition to those listed after such a term in a claim are still deemedto fall within the scope of that claim. Moreover, in the followingclaims, the terms “first,” “second,” and “third,” etc. are used merelyas labels, and are not intended to impose numerical requirements ontheir objects.

Geometric terms, such as “parallel”, “perpendicular”, “round”, or“square”, are not intended to require absolute mathematical precision,unless the context indicates otherwise. Instead, such geometric termsallow for variations due to manufacturing or equivalent functions. Forexample, if an element is described as “round” or “generally round,” acomponent that is not precisely circular (e.g., one that is slightlyoblong or is a many-sided polygon) is still encompassed by thisdescription.

Method examples described herein can be machine or computer-implementedat least in part. Some examples can include a computer-readable mediumor machine-readable medium encoded with instructions operable toconfigure an electronic device to perform methods as described in theabove examples. An implementation of such methods can include code, suchas microcode, assembly language code, a higher-level language code, orthe like. Such code can include computer readable instructions forperforming various methods. The code may form portions of computerprogram products. Further, in an example, the code can be tangiblystored on one or more volatile, non-transitory, or non-volatile tangiblecomputer-readable media, such as during execution or at other times.Examples of these tangible computer-readable media can include, but arenot limited to, hard disks, removable magnetic disks, removable opticaldisks (e.g., compact disks and digital video disks), magnetic cassettes,memory cards or sticks, random access memories (RAMs), read onlymemories (ROMs), and the like.

The above description is intended to be illustrative, and notrestrictive. For example, the above-described examples (or one or moreaspects thereof) may be used in combination with each other. Otherembodiments can be used, such as by one of ordinary skill in the artupon reviewing the above description. The Abstract is provided to complywith 37 C.F.R. § 1.72(b), to allow the reader to quickly ascertain thenature of the technical disclosure. It is submitted with theunderstanding that it will not be used to interpret or limit the scopeor meaning of the claims. Also, in the above Detailed Description,various features may be grouped together to streamline the disclosure.This should not be interpreted as intending that an unclaimed disclosedfeature is essential to any claim. Rather, inventive subject matter maylie in less than all features of a particular disclosed embodiment.Thus, the following claims are hereby incorporated into the DetailedDescription as examples or embodiments, with each claim standing on itsown as a separate embodiment, and it is contemplated that suchembodiments can be combined with each other in various combinations orpermutations. The scope of the invention should be determined withreference to the appended claims, along with the full scope ofequivalents to which such claims are entitled.

What is claimed is:
 1. An anatomy simulator, comprising: a guide bodyhaving one or more faces; a first simulator socket forming a recess in afirst face of the one or more faces, wherein: the first simulator socketis configured to receive a first plate; and the first simulator socketincludes a first base portion; and a bore extending from the baseportion of the first simulator socket to an interior of the anatomysimulator, wherein the bore is configured to receive an alignmentmechanism; wherein the first base portion is angled at a first anglewith respect to the first face.
 2. The anatomy simulator of claim 1,wherein the first plate and the alignment mechanism are configured tocouple at one or more orientations and coupling the first plate with thealignment mechanism fixes the orientation of the first plate withrespect to the alignment mechanism.
 3. The anatomy simulator of claim 1,wherein the first simulator socket is configured to receive the firstplate such that mating the first plate with the alignment mechanism andwith the first base portion establishes the first angle between thefirst plate and the alignment mechanism.
 4. The anatomy simulator ofclaim 3, wherein a portion of the alignment mechanism isquasi-spherical, and the quasi-spherical portion is configured to bereceived by a plate socket of the first plate.
 5. The anatomy simulatorof claim 4, wherein the quasi-spherical portion includes an expansionbore, wherein the expansion bore is configured to receive an expansionpin, the expansion pin expanding the quasi-spherical portion from afirst diameter to a second diameter.
 6. The anatomy simulator of claim4, wherein expanding the quasi-spherical portion from a first diameterto a second diameter couples the first plate with the alignmentmechanism and fixes the orientation of the first plate with respect tothe alignment mechanism.
 7. The anatomy simulator of claim 1, whereinthe first simulator socket is included in a plurality of simulatorsockets and each of the one or more faces includes an individualsimulator socket of the plurality of sockets.
 8. The anatomy simulatorof claim 1, further comprising simulator indicia on the first faceconfigured to provide alphanumerical information identifying the firstangle.
 9. The anatomy simulator of claim 1, wherein the first socketincludes one or more indicator portions configured to be aligned with analignment indicia of the first plate.
 10. The anatomy simulator of claim1, wherein the bore is configured to extend orthogonally to the firstface.
 11. The anatomy simulator of claim 1, wherein the alignmentmechanism is a guide wire.
 12. The anatomy simulator of claim 1,wherein: the first face includes a first simulator indicia configured toprovide alphanumerical information identifying the first angle; thefirst simulator socket includes a first indicator portion configured toreceive an alignment indicia of the first plate; and wherein aligningthe alignment indicia with the first indicator portion and mating thefirst plate with the anatomy simulator imparts the first angle onto thefirst plate with respect to the first face.
 13. The anatomy simulator ofclaim 1, further comprising the first plate, the first plate comprising:a first plate surface configured to couple with an anatomical feature ofa patient; a second plate surface opposite the first plate surface, aplate socket extending into the first plate surface; and a boreextending from the socket to the second guide plate surface to allow aguide wire to translate through the guide plate.
 14. A method forcalibrating adjustable orthopaedic devices, comprising: identifying ananatomical geometry of an anatomical feature of the patient, wherein thegeometry of the anatomical feature includes an anatomical axis and theanatomical geometry is at one or more angles with respect to theanatomical axis; coupling an alignment mechanism to an anatomysimulator, wherein the anatomy simulator is configured to reproduce theone or more angles with respect to the alignment mechanism; and couplinga first plate with the anatomy simulator, wherein coupling the firstplate with the anatomy simulator includes mating the first plate with abase portion of the anatomy simulator, wherein the mating of the firstplate with the base portion establishes the first plate at the one ormore angles with respect to the alignment mechanism.
 15. The method ofclaim 14, further comprising coupling an axis guide to the first plate,wherein the alignment mechanism comprises a first guide wire andcoupling the axis guide includes translating the first guide wirethrough an axis guide wire bore of the axis guide, the axis guide wirebore configured to receive the first guide wire in a single orientation.16. The method of claim 15, further comprising decoupling the firstplate and the axis guide as a unit from the anatomy simulator.
 17. Themethod of claim 16, further comprising placing a guide wire in theanatomical feature of the patient, wherein the coupling of the axisguide with the guide plate allows the guide wire to be located at theanatomical axis of the anatomical feature.
 18. The method of claim 14,wherein mating the first plate with anatomy simulator includes matingthe first plate with the alignment mechanism and establishing the firstangle between the first plate and the alignment mechanism with the baseportion of the anatomy simulator.
 19. The method of claim 18, whereinthe first plate and the alignment mechanism are configured to couple atone or more orientations and coupling the first plate with the alignmentmechanism fixes the orientation of the first plate with respect to thealignment mechanism.
 20. The method of claim 19, wherein a portion ofthe alignment mechanism is quasi-spherical, and the quasi-sphericalportion is configured to be received by a plate socket of the firstplate.